title: Applied pharmacogenomics in cardiovascular medicine.
abstract: Interindividual heterogeneity in drug response is a central feature of all drug therapies. Studies in individual patients, families, and populations over the past several decades have identified variants in genes encoding drug elimination or drug target pathways that in some cases contribute substantially to variable efficacy and toxicity. Important associations of pharmacogenomics in cardiovascular medicine include clopidogrel and risk for in-stent thrombosis, steady-state warfarin dose, myotoxicity with simvastatin, and certain drug-induced arrhythmias. This review describes methods used to accumulate and validate these findings and points to approaches--now being put in place at some centers--to implementing them in clinical care.
authors.affiliation: Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; email: peter.e.weeke@vanderbilt.edu , dan.roden@vanderbilt.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.forename: Dan M
authors.initials: DM
authors.lastname: Roden
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents; D000991:Antithrombins / Q000378:metabolism / Q000627:therapeutic use*; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D065729:Cytochrome P-450 CYP2C9; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D027381:Liver-Specific Organic Anion Transporter 1; D027361:Organic Anion Transporters / Q000235:genetics; D010597:Pharmacogenetics / Q000639:trends; D020641:Polymorphism, Single Nucleotide; D057285:Precision Medicine; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000378:metabolism / Q000627:therapeutic use; D064417:Vitamin K Epoxide Reductases / Q000235:genetics; D014859:Warfarin / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D000991:Antithrombins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D027381:Liver-Specific Organic Anion Transporter 1; D027361:Organic Anion Transporters; C503999:SLCO1B1 protein, human; D014859:Warfarin; D000077144:Clopidogrel; C450260:CYP2C9 protein, human; D065729:Cytochrome P-450 CYP2C9; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; C578523:VKORC1 protein, human; D064417:Vitamin K Epoxide Reductases; D013988:Ticlopidine